Vasotec: Advanced Blood Pressure Control for Cardiovascular Health
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Vasotec (Enalapril Maleate) is an ACE inhibitor medication clinically proven to manage hypertension and improve cardiac function. This prescription drug works by relaxing blood vessels, allowing blood to flow more smoothly and reducing strain on the heart. With decades of clinical validation, Vasotec represents a cornerstone therapy in cardiovascular medicine, offering physicians a reliable option for patients requiring systematic blood pressure management. Its dual-action mechanism addresses both hypertension and heart failure symptoms, making it a versatile choice in comprehensive treatment plans.
Features
- Active ingredient: Enalapril Maleate
- Drug class: Angiotensin-Converting Enzyme (ACE) inhibitor
- Available in tablet formulations: 2.5 mg, 5 mg, 10 mg, 20 mg
- Once or twice-daily dosing regimen
- Bioavailability: Approximately 60% when orally administered
- Peak plasma concentration: Reached within 3-4 hours post-administration
- Half-life: 11 hours (prolonged in renal impairment)
- Metabolism: Hepatic hydrolysis to active metabolite enalaprilat
- Excretion: Primarily renal (60% as enalaprilat)
Benefits
- Effective hypertension management: Demonstrated reduction in both systolic and diastolic blood pressure measurements
- Heart failure symptom improvement: Enhanced cardiac output and reduced hospitalizations in congestive heart failure patients
- Renoprotective effects: Slows progression of diabetic nephropathy and reduces proteinuria
- Afterload reduction: Decreases myocardial oxygen demand, beneficial for patients with coronary artery disease
- Long-term cardiovascular protection: Reduces risk of myocardial infarction, stroke, and cardiovascular mortality
- Flexible dosing: Allows for individualized titration based on patient response and renal function
Common use
Vasotec is primarily indicated for the treatment of hypertension, either as monotherapy or in combination with thiazide diuretics. It is also FDA-approved for management of symptomatic heart failure, often used alongside diuretics and digitalis. Additionally, physicians may prescribe Vasotec for diabetic nephropathy management, particularly in patients with type 1 diabetes and proteinuria. Off-label uses include prevention of left ventricular dysfunction following myocardial infarction and management of scleroderma renal crisis.
Dosage and direction
Hypertension: Initial dose typically 5 mg once daily, adjustable to maintenance dose of 10-40 mg daily in single or divided doses. Heart failure: Initiate at 2.5 mg once daily, titrating upward to target maintenance dose of 10-20 mg twice daily. Renal impairment: Requires dosage adjustment based on creatinine clearance. Administration should occur at approximately the same time each day, with or without food. Tablets should be swallowed whole with water, not crushed or chewed.
Precautions
Monitor blood pressure regularly during initial therapy and following dosage adjustments. Assess renal function and serum potassium before initiation and periodically during treatment. Exercise caution in patients with renal artery stenosis, collagen vascular diseases, or those undergoing major surgery. Avoid rapid dosage escalation in volume-depleted patients. Pregnancy requires immediate discontinuation due to fetal risk. Lactation is not recommended during therapy.
Contraindications
History of angioedema related to previous ACE inhibitor treatment. Patients with hereditary or idiopathic angioedema. Concomitant use with aliskiren in patients with diabetes. Known hypersensitivity to enalapril or any component of the formulation. Concomitant use with neprilysin inhibitors.
Possible side effect
Common reactions include dizziness (2-8%), headache (2-5%), fatigue (2-3%), and cough (1-2%). Less frequent effects may include orthostatic hypotension, hyperkalemia, renal impairment, angioedema, and taste disturbance. Rare serious adverse events include neutropenia, agranulocytosis, hepatic failure, and anaphylactoid reactions. Most side effects are dose-dependent and often diminish with continued therapy.
Drug interaction
Potassium supplements/potassium-sparing diuretics: Increased risk of hyperkalemia. Lithium: Reduced lithium clearance, potential toxicity. NSAIDs: May diminish antihypertensive effect and increase renal impairment risk. Diuretics: Potentiated hypotensive effect, especially after first dose. Gold injections: Nitritoid reactions reported. Antidiabetic agents: Enhanced hypoglycemic effects possible. MTOR inhibitors: Increased angioedema risk.
Missed dose
If a dose is missed, take it as soon as remembered unless it is nearly time for the next scheduled dose. Do not double the dose to make up for a missed administration. Maintain regular dosing schedule to ensure consistent therapeutic effect. Patients should establish routine administration habits to minimize missed doses.
Overdose
Symptoms may include profound hypotension, bradycardia, circulatory shock, electrolyte disturbances, and renal failure. Management involves supportive care including volume expansion with normal saline. Hemodialysis may be effective for removing enalaprilat. Angiotensin II infusion may be considered for reversing effects. Continuous hemodynamic monitoring is essential in overdose situations.
Storage
Store at controlled room temperature (20-25°C or 68-77°F). Protect from moisture and light. Keep container tightly closed. Do not remove desiccant from packaging. Keep out of reach of children and pets. Do not use after expiration date printed on packaging. Properly dispose of unused medication through take-back programs.
Disclaimer
This information does not replace professional medical advice. Vasotec requires prescription and medical supervision. Individual response to medication may vary. Patients should not initiate, discontinue, or modify dosage without consulting their healthcare provider. Full prescribing information should be reviewed before administration.
Reviews
Clinical studies demonstrate Vasotec’s efficacy with 70-80% of hypertensive patients achieving blood pressure control. Cardiologists frequently report satisfactory patient outcomes in heart failure management. Some patients note persistent cough as a limiting factor, while others appreciate the once-daily convenience. Long-term users often report stable control with minimal side effects after initial adjustment period.